June 7, 2024

FYI.  Please see notice below and attached.

Important Communication: Exception to Medicaid Provider Enrollment for Unlicensed Interns, Residents & Foreign Physicians in Training Programs 

Unlicensed Interns, Residents and Foreign Physicians in Training Programs are eligible to prescribe for Medicaid members in NYRx, the Medicaid Pharmacy program, without enrollment as a Medicaid provider. In accordance with NYS Education Law, unlicensed interns, residents, and foreign physicians participating in training programs, are authorized to prescribe. NYS Medicaid recognizes the authority under which these unlicensed providers may prescribe; however, per federal requirements these physicians are not eligible for enrollment into the NYS Medicaid program without a license. 

Pharmacies billing for prescriptions written by Unlicensed Interns, Residents and Foreign Physicians in Training Programs will need to utilize point of service overrides for claim submission. NYRx has billing guidance exceptions (see attached) in place to be utilized at the pharmacy point of service for the enrollment requirement. These overrides will allow prescriptions written by unlicensed interns, residents and foreign physicians participating in training programs to bypass enrollment editing.

Medicaid Pharmacy Policy
Division of Program Development and Management